My Best Doctor

Causes of Erectile Dysfunction (Impotence)

The following are some of the different types and possible causes of impotence:

• Premature ejaculation (PE)
  Premature ejaculation is the inability to maintain an erection long enough for mutual satisfaction. Premature ejaculation is divided into primary and secondary forms:
  • primary premature ejaculation
    Primary premature ejaculation is a learned behavior that begins when a male first become sexually active. Like any learned behaviors, it can be unlearned. This form of primary PE is psychogenic (as opposed to organic or physical) impotence. (Congenital venous leak is a subset of primary PE and is caused by a congenital venous leak in which the venous drainage system in the penis does not shut down properly.)
  • secondary premature ejaculation
    Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both.

• Performance anxiety
  Performance anxiety is a form of psychogenic impotence -usually caused by stress or anxiety.

• Depression
  Depression is another cause of psychogenic impotence. Some antidepressant medications cause erectile failure.
• Organic impotence
  Organic impotence involves the penile arteries, veins, or both, and is the most common cause of impotence, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. The controllable risk factors for arteriosclerosis – being overweight, lack of exercise, high cholesterol, high blood pressure, and cigarette smoking – can cause erectile failure often before progressing to affect the heart. Many experts believe that when veins are the cause, a venous leak or “cavernosal failure” is the most common vascular problem.

• Diabetes
  Impotence is common in persons with diabetes. Every 5^th Mumbaikar is a Diabetic, Infact by 2020 India shall be the Diabetes Capital of the world. and it is estimated that 35 percent to 50 percent of Diabetics have Erectile dysfunction.. The process involves premature and unusually severe hardening of the arteries. Peripheral neuropathy, with involvement of the nerves controlling erections, is commonly seen in persons with diabetes.
• Neurologic causes
  There are many neurological (nerve problems) causes of impotence. Diabetes, chronic alcoholism, multiple sclerosis, heavy metal poisoning, spinal cord and nerve injuries, and nerve damage from pelvic operations can cause erectile dysfunction.
• Drug-induced impotence
  A great variety of prescription drugs, such as blood pressure medications, anti-anxiety and antidepressant medications, glaucoma eye drops, and cancer chemotherapy agents are just some of the many medications associated with impotence.
• Hormone-induced impotence
  Hormonal abnormalities such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by body-builders which is become a passion today in youngsters who join the mushrooming business of gyms in metros of India, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause impotence. Rarely is low testosterone responsible for impotence.